2. Your Name*
4. Adopt-a-Road Organization Name, e.g. Birch Bay Watershed Watchers*
6. Date*
8. Total Volunteers in Crew*
10. Roadway/Beach that was cleaned*
12. Approximate Number of Miles or Acres Covered*
14. Number of Litter Bags Filled*
16. Number of Hours Worked*
18. Comments
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20. 1. Receive an email copy of this form.
21. Email address

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22. Submit

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